Allergic rhinitis (AR) is a common respiratory disease affecting both adults and children
worldwide. Affected patients may experience nasal congestion/stuffiness, rhinorrhea (anterior and/or posterior), nasal/
nasopharyngeal itching and sneezing. Allergen avoidance is the principal step in the management. Nasal saline irrigation
to remove allergen (s) in the nose is a useful adjunctive therapy in the management of moderate to severe AR. Symptomatic
relief and improved quality of life may be achieved in the majority of patients with appropriate pharmacotherapy.
Mild-to-moderate cases are usually managed with either an oral second generation antihistamine or an intranasal corticosteroid.
More severe cases may require treatment with an intranasal corticosteroid in combination with various oral medications.
Patients who require medications for more than 6 months per year or have intolerable side effects from pharmacotherapy
can be considered for immunotherapy. A wide range of complementary and alternative medicines (CAM) have
also been proposed. This overview evaluates the evidence of use of CAM for AR. Some methods including acupuncture
and herbal medicine have supportive evidence, but the efficacy of other CAM is controversial. Conversely, possible side
effects of different modalities are often inadequately documented. The herbal formulae include Butterbur, Nigella sativa,
Shi-Bi-Lin, Polyherbal formula, Grapeseed extract, Rosmarinic acid, Spirulina, Biminne, and Bhu-zhong-yi-qi-tong. Further
research is needed to assess the efficacy and safety before they are employed in treating AR. This review article also
discusses recent CAM patents for use in AR, which are exclusively traditional Chinese medicine (TCM) concoctions primarily
for oral consumption but two as topical spray. Only 8 pertinent patents, all TCM compositions for treating AR
and registered in 2014, were obtained. Description about their efficacy is impressive but objective outcome evaluation
tools are lacking.
Keywords: Allergen avoidance, allergic rhinitis, combination therapy, complementary and alternative medicine, hay fever,
herbs, immunotherapy, pharmacotherapy, intranasal corticosteroid, oral antihistamine, randomized trials, systematic reviews,
traditional Chinese medicine.
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